Giving birth after interstitial ectopic - c section?

Hi, wondered if anyone who has been or is in a similar position can give me some advice? I had surgery for an interstitial ectopic in January and I am now 36 weeks pregnant. I made my midwife aware of the previous surgery when I booked in but was marked as low risk. This is despite being listed as high risk due to the previous surgery when I booked in first in a different area (I moved house so then needed to book in again). Nothing has been mentioned about the surgery and any impact this might have on a natural delivery, so at my last midwife appointment 3 weeks ago I asked about it and the midwife started explaining that it wasn’t a problem as ectopic pregnancies affect the tubes and not the uterus so I had to correct her that they do actually occur in other places and in my case, the uterus (the uterine lining). She said she would refer me to a consultant but I’ve not heard anything from them about an appointment. I have my next midwife appointment tomorrow so I am going to raise it again but I’d really love to have something to back up my concerns with, like other people’s experiences, as I have a feeling I will be fobbed off again.

I cried myself to sleep last night after reading numerous articles about the risks of uterine rupture from natural birth, if the uterus has previously been operated on. Everything I’ve read suggests that a caesarean is required to remove this particular risk, and I remember my surgeon’s assistant saying something about a c section if I do get pregnant again. But I can’t believe I’m the one having to bring this information to their attention and fight to be listened to. Apparently there is a 6% chance or a rupture which can lead to the baby going through the rupture and suffocating. This might seem like a small percentage but when you start with a 1-2% chance of having an ectopic in the first place, followed by a 2-4% chance of it being interstitial- all of which happened, 6% seems huge to me. I’ve already lost one baby this year and I’m petrified of losing another. Has anyone else had this surgery for ectopic previously and then had discussions about birth options with their midwife or consultant?? I had a hysteroscopy and laproscopy. Thank you!

Dear Scarmhas,

I am so sorry it has taken me a while to reply, I was seeking clarity from the team.

The information I received is as follows-

It is possible to have successful uterine pregnancies after an interstitial pregnancy. Your doctor will assess you carefully and consider the need for an elective caesarean section to deliver any subsequent pregnancy and the preferred method of delivery will depend on the extent of the surgery necessary on the uterine wall to resolve the ectopic pregnancy.

It maybe worth asking about your NHS trusts policy, but I would say there is a strong case for patient choice too and I would make your feelings known to your midwife and medical team so you can discuss further. I hope you had some further joy with the midwife today.

Sending much love,

Karen x

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